Provider Demographics
NPI:1790473924
Name:DANDRIDGE, CAMILLE ROSE (RN)
Entity type:Individual
Prefix:
First Name:CAMILLE
Middle Name:ROSE
Last Name:DANDRIDGE
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:5610 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-2536
Mailing Address - Country:US
Mailing Address - Phone:804-614-6401
Mailing Address - Fax:
Practice Address - Street 1:1215 LEE STREET
Practice Address - Street 2:PO BOX 800634
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908
Practice Address - Country:US
Practice Address - Phone:434-982-0655
Practice Address - Fax:434-982-3972
Is Sole Proprietor?:No
Enumeration Date:2023-04-26
Last Update Date:2025-02-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0024192438367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered